Age as a prognostic factor for patients with osteosarcoma: an analysis of 438 patients

Harting, Matthew T.; Lally, Kevin P.; Andrassy, Richard J.; Vaporciyan, Ara A.; Cox, Charles S.; Hayes‐Jordan, Andrea; Blakely, Martin L.

doi:10.1007/s00432-009-0690-5

Cited by 66 publications

(69 citation statements)

References 23 publications

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“…Consistent with prior reports, tumor size, 7,14,31,32 anatomic site, 7,13,15,32 and metastatic status at presentation 7,10,31,33,34 were strong determinants of survival outcome. After adjusting for these parameters, tumor subtype retained independent prognostic significance.…”

Section: Discussionsupporting

confidence: 87%

Histopathologic Features of Prognostic Significance in High-Grade Osteosarcoma

Chui

Kandel²,

Wong³

et al. 2016

Archives of Pathology &Amp; Laboratory Medicine

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Context.-In osteosarcoma treated with neoadjuvant chemotherapy the extent of tumor necrosis on resection is considered an indicator of treatment response, and this has been shown to correlate with survival in most but not all studies.Objective.-To identify additional histologic variables of prognostic significance in high-grade osteosarcoma.Design.-Slides of pretreatment biopsy and primary postneoadjuvant chemotherapy resections from 165 patients with high-grade osteosarcoma were reviewed. Univariate (Kaplan-Meier) and multivariate (Cox regression) analyses were performed to identify clinical and histomorphologic attributes associated with overall survival.Results.-Univariate analyses confirmed the prognostic significance of metastatic status on presentation, primary tumor size, anatomic site, and histologic subtype. Additionally, the identification of lymphovascular invasion, 10% or more residual viable tumor, and 10 or more mitoses per 10 high-powered fields assessed in posttreatment resections were associated with poor survival, retaining significance in multivariate analyses. Based on results from multivariate analysis, we developed a prognostic index incorporating primary tumor size and site, and significant histologic features assessed on resection (ie, lymphovascular invasion status, mitotic rate, and extent of viable tumor). This scoring system segregates patients into 3 risk categories with significant differences in overall survival and retained significance in an independent validation set of 42 cases.Conclusions.-The integration of clinical and microscopic features improves prognostication of patients with osteosarcoma.

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Section: Discussionsupporting

confidence: 87%

Histopathologic Features of Prognostic Significance in High-Grade Osteosarcoma

Chui

Kandel²,

Wong³

et al. 2016

Archives of Pathology &Amp; Laboratory Medicine

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“…Similar to the situation involving advancing age, prior research on osteosarcoma revealed that tumors in the axial skeleton and large tumors were associated with a poor prognosis 5,[8][9][10]16,21 . The inferior oncologic results in these cases can be partially explained by the difficulty in performing surgical resection and obtaining adequate margins 3,5 .…”

mentioning

confidence: 89%

“…Many previous studies have revealed an association of increasing age with a poorer prognosis in patients with osteosarcoma [5][6][7]10,16,17 . However, there is substantial uncertainty and debate regarding whether age itself is a risk factor or is simply a surrogate for other, more important, aspects of the disease.…”

mentioning

confidence: 99%

“…However, there is substantial uncertainty and debate regarding whether age itself is a risk factor or is simply a surrogate for other, more important, aspects of the disease. For instance, older patients have greater percentages of axial and large tumors, both of which are associated with a poorer prognosis 16,[18][19][20][21] . Greater angiogenesis in the tumors in older individuals may also contribute to the greater prevalence of early metastasis 18 .…”

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confidence: 99%

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Risk Factors for Metastatic Disease at Presentation with Osteosarcoma

Miller

Cram

Lynch

et al. 2013

Journal of Bone and Joint Surgery

156

126

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“…Similar report by Hagleitner et al [13] in Netherland also concluded that younger patients had significantly better outcome than older patients, but their statement was depend on OS and EFS rates of 5-year, which means that longer-term follow-up such as our 10-year OS and EFS rates might have produced different outcomes. In a study by Hartling et al [14] at M.D. Anderson Cancer Center, patient group of aged 21 -40 years presented relatively better OS rate and less RR (risk ratio) than the other age groups, although these were not statistically significant values and they concluded that age at diagnosis did not seem to be a significant prognostic factor.…”

Section: Discussionmentioning

confidence: 95%

Is Osteosarcoma between the Two Peak Ages Different?

Chung¹,

Cho²,

Jeon³

et al. 2018

JCT

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Background: Unlike two known peak age groups (10 -14 and older than 65 years of age), there was relatively scant attention in osteosarcoma patients between them, and previous reports had analyzed other than Asians. Therefore we conducted this study with Korean patients and focused on 20 -40 years of age, then investigated age-specific or race-specific meaningful outcomes. Materials and Methods: 379 patients who were newly diagnosed as osteosarcoma in two Korean major cancer hospitals from September 1986 to July 2015 with more than 2-year follow-up were retrospectively studied. There were 290 patients with 20 -40 years of age, 60 patients aged 19 or younger, and 29 patients aged 41 or older. Age at diagnosis, gender, location of primary lesion, metastasis at diagnosis, histologic subtypes, histologic response were analyzed as prognostic factors by overall survival (OS) and event-free survival (EFS) rates. Results: Primary pelvic lesion and poor histologic response were significantly unfavorable prognostic factors, but not age-specific. However, proportion of metastasis at diagnosis was significantly highest in 20 -40 years of age group. For the age at diagnosis, older patients presented poorer 5-year OS and EFS rates, but for 10-year, 20 -40 years of age group showed unusually better prognosis than younger age's, with statistic significance in OS rates but not in EFS rates. Conclusion: Osteosarcoma patients with 20 -40 years of age in Korea presented relatively better prognosis after longer-term 10-year despite their late diagnosis causing more metastasis at diagnosis, which emphasized expedite diagnosis and appropriate treatment to expect much better prognosis than peak age groups.

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Age as a prognostic factor for patients with osteosarcoma: an analysis of 438 patients

Cited by 66 publications

References 23 publications

Histopathologic Features of Prognostic Significance in High-Grade Osteosarcoma

Histopathologic Features of Prognostic Significance in High-Grade Osteosarcoma

Risk Factors for Metastatic Disease at Presentation with Osteosarcoma

Is Osteosarcoma between the Two Peak Ages Different?

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